sucralfate 100 MG/ML Oral Suspension [Carafate]
sucralfate
RxCUI: 208094
What the CMS Formulary Data Shows for sucralfate 100 MG/ML Oral Suspension [Carafate]
Per the CMS 2026 Part D formulary file, sucralfate 100 MG/ML Oral Suspension [Carafate] (RxNorm concept RXCUI 208094, generic name sucralfate) appears on 4 distinct formulary files spanning 19 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.8.
Real-world access to sucralfate 100 MG/ML Oral Suspension [Carafate] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 800,942 Part D beneficiaries filled sucralfate 100 MG/ML Oral Suspension [Carafate] in 2023, with total plan-and-beneficiary spending of $160,271,432 and an average per-beneficiary annual cost of $200.10. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sucralfate 100 MG/ML Oral Suspension [Carafate] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 19
- Coverage rate
- 0.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 800,942
- Total spending
- $160,271,432
- Avg per beneficiary
- $200.10
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sucralfate 100 MG/ML Oral Suspension [Carafate]
19 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $0 | DE |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
Frequently Asked Questions
Is sucralfate 100 MG/ML Oral Suspension [Carafate] covered by Medicare Part D?
Yes, sucralfate 100 MG/ML Oral Suspension [Carafate] is covered by 19 Medicare Part D plans (0.4% of all Part D formularies).
What tier is sucralfate 100 MG/ML Oral Suspension [Carafate] on Medicare Part D plans?
sucralfate 100 MG/ML Oral Suspension [Carafate] averages Tier 1.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does sucralfate 100 MG/ML Oral Suspension [Carafate] require prior authorization?
0% of Part D formularies require prior authorization for sucralfate 100 MG/ML Oral Suspension [Carafate]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on sucralfate 100 MG/ML Oral Suspension [Carafate]?
In 2023, total Medicare Part D spending on sucralfate 100 MG/ML Oral Suspension [Carafate] was $160,271,432, covering 800,942 beneficiaries. The average spend per beneficiary was $200.10.
Read our methodology - how this data is sourced, computed, and verified.